COVID-19 Risk Compensation? Examining Vaccination Uptake among Recovered and Classification of Breakthrough Cases

Arielle Kaim*, Gal Zeevy, Mor Saban

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The study has two primary aims: the first is to examine the uptake of COVID-19 vaccination patterns among those previously infected, and the second is an evaluation of the period elapsed between the patient’s latest dose of the vaccine and the infection itself by demographic group. A retrospective study was conducted from 1 March 2020, to 31 May 2022, in Israel. The study found that among Israelis, vaccination uptake following infection is relatively low. When examining gender, one sees that the immunization rate among recovering females is higher than among men. Similarly, differences in uptake exist between age groups. When examining the interval between vaccine dose and infection according to age groups, the most significant breakthrough infection rate is among the ages of 20–59 (1–6 days—0.3%; 7–13 days—0.48%; two to three weeks—0.3%, p < 0.001). This study reveals potential reservoir groups of virus spread. Among previously infected, low vaccination uptake levels are observed (first dose—30–40%, second dose—16–27%, third dose—9% and fourth dose—2%, p < 0.001), despite findings that indicate surging reinfection rates. Among vaccinated, two critical groups (0–19; 20–59) exhibit highest levels of breakthrough cases varying per vaccine doses, with statistically significant findings (p < 0.001). These population groups may be subject to a false sense of security as a result of perceived acquired long-term immunity prompting low perceived risk of the virus and non-vigilance with protective behavior. The findings point to the possibility that individuals engage in more risky health behavior, per the Peltzman effect.

Original languageEnglish
Article number58
JournalHealthcare (Switzerland)
Issue number1
StatePublished - Jan 2023


  • COVID-19
  • breakthrough cases
  • immunity
  • reinfection
  • vaccination uptake


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